Affordable Care Act

The ACA MarketplaceS

What We Know about Trump’s $500 ACA Checks and the User Fees Funding Them

This analysis examines the $500 checks that the Trump administration is sending to some Affordable Care Act Marketplace enrollees and the user fees that are paying for them. The checks are going to about 1 million enrollees in the 30 states that rely on the federal HealthCare.gov Marketplace who are not receiving any tax credits this year.

Individual Market Enrollment Declined by 18% Since June 2025

Individual Market Enrollment Fell 18%, Suggesting Continued ACA Marketplace Losses

Enrollment in the individual health insurance market fell by 18%—over 4.6 million people—from 25.2 million in June 2025 to 20.5 million in June 2026. Falling individual market enrollment suggests further decline in ACA Marketplace enrollment this year, since Marketplace enrollees represent the vast majority of individual market coverage. The enrollment decline coincides with the expiration of the enhanced premium tax credits and other policy changes that are expected to reduce enrollment.

About the ACA

Promotional image for KFF video How Affordable is the Affordable Care Act

Did the Affordable Care Act Make Health Care More Affordable?

The expiration of the ACA’s enhanced premium tax credits at the start of 2026, combined with rising insurer premiums, put a spotlight on health care affordability that extends beyond Marketplace enrollees. KFF’s Cynthia Cox examines the ACA’s record and the broader underlying question it raises: what’s a fair price for Americans people to pay for health care?

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  • Tracking Section 1332 State Innovation Waivers

    Fact Sheet

    This interactive map shows the status of all Section 1332 waivers requested by states. The Affordable Care Act (ACA) allows states to apply for innovation waivers to alter key ACA requirements in the individual and small group insurance markets and can be used to shore up fragile insurance markets, address unique state insurance market issues, or experiment with alternative models of providing coverage to state residents.

  • Updated Subsidy Calculator and 300+ FAQs Help Consumers Understand the ACA Marketplaces as Open Enrollment Begins

    News Release

    Ahead of the annual Affordable Care Act (ACA) open enrollment period, the time during which consumers can shop for health plans or renew existing coverage, KFF has updated its Health Insurance Marketplace Calculator and its searchable collection of more than 300 Frequently Asked Questions about open enrollment, the health insurance marketplaces and the ACA. KFF’s Health Insurance Marketplace Calculator provides estimates of 2021 health insurance premiums and subsidies for people purchasing insurance on their own in health…

  • What Happens to Medicaid Drug Policy if the ACA is Overturned?

    Issue Brief

    The repeal of the ACA could mean loss of Medicaid coverage for up to 15 million that were enrolled in the ACA Medicaid expansion group prior to the COVID-19 pandemic; however, repeal could also mean significant changes to Medicaid prescription drug policy with implications for state and federal spending for prescription drugs for non-expansion Medicaid enrollees.

  • Health Policy Resources for Covering the 2020 Elections

    News Release

    As the 2020 Election Day approaches, many candidates continue to focus on health care issues, including on the public health and economic response to COVID-19, the future of the Affordable Care Act, health care costs and abortion. To help reporters understand and cover these issues, KFF offers independent, non-partisan policy analysis, polling and other research and has experts who can provide context, explain trade-offs and provide key data points on health care issues that may arise…

  • Joe Biden’s Big Lead on Health Care Issues

    From Drew Altman

    In an Axios column, Drew Altman discusses how this election year health isn’t a single issue -- but several -- and Joe Biden has the edge over President Trump on all of them, even as opposition to the ACA remains popular with Trump’s base.